Histopathologically proven prevention of post-prostatectomy cavernosal fibrosis with sildenafil

To evaluate whether a dose of 50 mg preserved the architecture of the corpora cavernosa biopsy in man.

21 patients (54-70 years old) who underwent radical prostatectomy for prostate cancer were treated with sildenafil citrate (50 mg, 3 times a week for 2 months) soon after surgery. They underwent cavernous biopsy before surgery and after 2 months of sildenafil treatment. Biopsy tissues were fixed in formalin, stained with Masson's trichrome method, and evaluated with the Eureka Interface system with a per-area analysis, and elastic fibers were counted on 10-12 fields (x400) of five serial sections.

Two months after surgery the percent of connective tissue in cavernosa samples in all patients did not differ from that before surgery, being between 30 and 40% in the per-area analysis. Similarly, the elastic fiber count did not differ significantly before and after surgery.

Sildenafil prevented the progression of fibrosis in prostatectomized patients. Its efficacy seems to result from an antiproliferative effect exerted on fibroblasts.